Our actions are constantly guided by decisions based on sensory information. The motor cortex is traditionally viewed as the final output stage in this process, merely executing motor responses based on these decisions. However, it is not clear if, beyond this role, the motor cortex itself impacts response selection. Here, we report activity fluctuations over motor cortex measured using MEG, which are unrelated to choice content and predict responses to a visuomotor task seconds before decisions are made. These fluctuations are strongly influenced by the previous trial's response and predict a tendency to switch between response alternatives for consecutive decisions. This alternation behaviour depends on the size of neural signals still present from the previous response. Our results uncover a response-alternation bias in sensorimotor decision making. Furthermore, they suggest that motor cortex is more than an output stage and instead shapes response selection during sensorimotor decision making.